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2组病人年龄差异无统计学意义(P>0.05);与非PSD组相比,PSD组受教育年限、ADL评分更低,NIHSS评分、HAMD和HAMA评分更高,脑卒中次数更多(P < 0.05~P < 0.01)(见表 1)。
分组 n 男 女 年龄/岁 受教育年限/年 NIHSS/分 ADL/分 脑卒中次数 HAMD/分 HAMA/分 PSD组 88 33 55 67.30±10.13 5.77±4.49 2.10±2.57 85.61±20.18 1.47±0.62 14.10±4.93 13.89±5.81 非PSD组 112 68 44 68.29±10.20 7.13±4.69 1.07±1.68 93.76±11.85 1.25±0.47 2.38±2.38 2.93±3.10 t — 10.62△ 0.68 2.07 3.41 3.56 2.85 22.10 17.11 P — <0.01 >0.05 <0.05 <0.01 <0.01 <0.01 <0.01 <0.01 △示χ2值 表 1 2组病人临床相关资料比较(x±s)
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PSD组血清HDL-C水平明显高于非PSD组(P < 0.01),2组TG、TC和LDL-C水平差异均无统计学意义(P>0.05)(见表 2)。
血脂 n TG TC HDL-C LDL-C PSD组 88 1.51±0.74 4.50±1.18 1.27±0.32 2.77±0.96 非PSD组 112 1.51±0.82 4.29±0.95 1.14±0.30 2.70±0.90 t — 0.00 1.39 2.95 0.53 P — >0.05 >0.05 < 0.01 >0.05 表 2 2组病人血脂水平比较(x±s; mmol/L)
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脑卒中病人HAMD、HAMA评分与NIHSS评分、卒中次数、TC和HDL-C水平均呈正相关关系(P < 0.05~P < 0.01),与ADL评分均呈明显负相关关系(P < 0.01)(见表 3)。
文化 NIHSS ADL 卒中次数 TG TC HDL-C LDL-C HAMD HAMA 年龄 -0.347** -0.083 -0.136 -0.011 -0.065 -0.039 0.125 -0.082 -0.053 -0.070 文化 — -0.038 0.178* -0.074 -0.054 -0.162* -0.128 -0.021 -0.129 -0.128 NIHSS — — -0.635** 0.375** -0.028 0.057 -0.070 0.068 0.194** 0.181* ADL — — — -0.294** 0.061 0.023 0.062 0.016 -0.200** -0.189** 卒中次数 — — — — -0.030 -0.035 -0.040 -0.011 0.154* 0.139* TG — — — — — 0.406** -0.243** 0.251** -0.028 0.013 TC — — — — — — 0.210** 0.786** 0.139* 0.142* HDL-C — — — — — — — 0.076 0.204** 0.224** LDL-C — — — — — — — — 0.115 0.110 HAMD — — — — — — — — — 0.917** *P < 0.05,**P < 0.01 表 3 各个指标间的相关性分析(r)
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ADL评分和HDL-C水平均为脑卒中病人HAMD评分的独立影响因素(P < 0.01)(见表 4)。
自变量 B SE t P ADL -0.239 0.028 3.50 < 0.01 HDL 0.237 1.546 3.48 < 0.01 表 4 脑卒中病人HAMD评分的多元回归分析
卒中后抑郁与血脂的关系研究
Study on the relationship between post-stroke depression and blood lipid level
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摘要:
目的探讨脑卒中并发卒中后抑郁(PSD)与病人血脂之间的关系,为脑卒中的临床干预提供指导。 方法随机选取脑卒中病人200例,按照是否发生PSD分为PSD组88例和非PSD组112例。分别进行血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平检测并进行比较,对脑卒中病人各临床指标间的相关性进行分析,并分析其与脑卒中病人抑郁评分的相关性。 结果PSD组血清HDL-C水平明显高于非PSD组(P < 0.01),2组TG、TC和LDL-C水平差异均无统计学意义(P>0.05)。脑卒中病人HAMD、HAMA评分与NIHSS评分、卒中次数、TC和HDL-C水平均呈正相关关系(P < 0.05~P < 0.01),与ADL评分均呈明显负相关关系(P < 0.01)。ADL评分和HDL-C水平均为脑卒中病人HAMD评分的独立影响因素(P < 0.01)。 结论脂质代谢异常与PSD存在一定联系,对卒中病人进行血脂调节治疗过程中,应警惕PSD发生,及早识别PSD并进行干预以期改善卒中预后。 Abstract:ObjectiveTo explore the relationship between post-stroke depression(PSD) and blood lipid level, and provide the guidance for clinical intervention of stroke. MethodsTwo hundred patients with stroke were randomly selected, and divided into the PSD group(88 cases) and non-PSD group(112 cases) according to the occurrence of PSD.The serum levels of triglyceride(TG), total cholesterol(TC), high density lipoprotein(HDL-C) and low density lipoprotein(LDL-C) in two groups were detected, and compared between two groups.The correlation among clinical indicators and depression score of stroke patients were analyzed. ResultsThe serum level of HDL-C in PSD group was significantly higher than that in non-PSD group(P < 0.01), and the differences of the levels of TG, TC and LDL-C between two groups were not statistically significant(P>0.05).The HAMD and HAMA scores were positively correlated with the NIHSS scores, stroke times, TC and HDL-C levels(P < 0.05 to P < 0.01), and negatively correlated with the ADL score(P < 0.01).The ADL score and HDL-C level were the independent influencing factors of HAMD score in stroke patients(P < 0.01). ConclusionsThe abnormal lipid metabolism is associated with PSD to a certain extent.In the course of lipid regulation therapy for stroke patients, the occurrence of PSD should be vigilant, and the PSD should be identified and intervened as early as possible in order to improve the prognosis of stroke. -
Key words:
- post-stroke depression /
- stroke /
- blood lipid /
- high density lipoprotein
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表 1 2组病人临床相关资料比较(x±s)
分组 n 男 女 年龄/岁 受教育年限/年 NIHSS/分 ADL/分 脑卒中次数 HAMD/分 HAMA/分 PSD组 88 33 55 67.30±10.13 5.77±4.49 2.10±2.57 85.61±20.18 1.47±0.62 14.10±4.93 13.89±5.81 非PSD组 112 68 44 68.29±10.20 7.13±4.69 1.07±1.68 93.76±11.85 1.25±0.47 2.38±2.38 2.93±3.10 t — 10.62△ 0.68 2.07 3.41 3.56 2.85 22.10 17.11 P — <0.01 >0.05 <0.05 <0.01 <0.01 <0.01 <0.01 <0.01 △示χ2值 表 2 2组病人血脂水平比较(x±s; mmol/L)
血脂 n TG TC HDL-C LDL-C PSD组 88 1.51±0.74 4.50±1.18 1.27±0.32 2.77±0.96 非PSD组 112 1.51±0.82 4.29±0.95 1.14±0.30 2.70±0.90 t — 0.00 1.39 2.95 0.53 P — >0.05 >0.05 < 0.01 >0.05 表 3 各个指标间的相关性分析(r)
文化 NIHSS ADL 卒中次数 TG TC HDL-C LDL-C HAMD HAMA 年龄 -0.347** -0.083 -0.136 -0.011 -0.065 -0.039 0.125 -0.082 -0.053 -0.070 文化 — -0.038 0.178* -0.074 -0.054 -0.162* -0.128 -0.021 -0.129 -0.128 NIHSS — — -0.635** 0.375** -0.028 0.057 -0.070 0.068 0.194** 0.181* ADL — — — -0.294** 0.061 0.023 0.062 0.016 -0.200** -0.189** 卒中次数 — — — — -0.030 -0.035 -0.040 -0.011 0.154* 0.139* TG — — — — — 0.406** -0.243** 0.251** -0.028 0.013 TC — — — — — — 0.210** 0.786** 0.139* 0.142* HDL-C — — — — — — — 0.076 0.204** 0.224** LDL-C — — — — — — — — 0.115 0.110 HAMD — — — — — — — — — 0.917** *P < 0.05,**P < 0.01 表 4 脑卒中病人HAMD评分的多元回归分析
自变量 B SE t P ADL -0.239 0.028 3.50 < 0.01 HDL 0.237 1.546 3.48 < 0.01 -
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